In this blog post, we see the recent advances/innovations of the year 2022 that have leveled the playing field of Healthcare.
“Yesterday I was a dog. Today I'm a dog. Tomorrow I'll probably still be a dog. Sigh! There's so little hope for advancement.” Aren’t we glad we’re humans? Although we are the same human yesterday, today and tomorrow, we advance each day by learning new things that are added to our brain. I say this as each time we learn something, the neurons present in our brain for new connections and neuros, thus either making the existing neuronal pathways stronger or weaker.
The same brain of humans, as vast and wide as the ocean( I believe!) has led to development of crazy new innovations that have changed the playing field in healthcare this year.
As the year is ending, let us look back upon a few of them. Here are 3 innovations that have happened in the year of 2022.
On the top our list is:
VOICE FOR HEALTH:
Voice biomarkers
Did you know that your voice could be a feature used for diagnosis of a disease? Well, yes!
Due to the COVID-19 situation, research has been done to reduce the traditional face-to-face contact between a doctor and a patient.
Voice biomarkers is one of the innovations that has proved to be an asset in the coming days.
The voice of a person can be divided into three parts: verbal, vowel/syllable, and nonverbal vocalizations.
The majority of the research on vocal biomarkers has been done in the field of
neurodegenerative diseases, particularly Parkinson's disease, where voice disorders
are common and where voice changes are anticipated to be used as an early
diagnostic biomarker. Since individuals with depression frequently have high amounts of the stress hormone cortisol, vocal features are used to identify depression symptoms or
assess the severity of sadness.
Another approach is usage of vocal biomarkers in the cancers of the head and neck region. For eg, oropharyngeal cancer- "The masses in the back of the throat change the way the voice resonates, and the sound of the voice becomes muffled, like a hot potato voice."
Vocal cord cancer- “the first symptom is usually a change in voice because even the small cancers affect how your vocal cords vibrate. The quality of the sound will be rough," said Bensoussan. "As cancer grows, it can make the breathing passage smaller. In that case, you now hear a very rough voice with a breathing sound on inspiration called stridor due to changes in airflow."
These changes in voice are something only experts can pick up. Therefore, the reproduction of expertise by training the models is an ongoing research.
Another approach is the use of vocal biomarkers for coronary assessment.
A study was done by the Mayo Clinic, Sara et al where the voice biomarker was collected using a smartphone application.
The voice recordings were collected using the Vocalis Health smartphone application from 108 patients who underwent clinically indicated coronary angiography and followed them up for 24 months. The mean biomarker value was calculated from the voice biomarker which was derived from each recording (3 per person).
Although a few presented to the hospital with unstable angina, there was a strong relationship between the voice biomarker and presentation with chest pain as well as the development of significant coronary atherosclerosis.
Before occurrence of a more clinically significant event, voice analysis by neural mediation may show the up-regulation of the autonomic nervous system due to chest pain or ischemia.
Further work needs to be done to undermine its true value. If proven successful, it will be an important asset to healthcare.
2. Histotripsy- Tumors partially destroyed by sound don’t come back
Histotripsy is defined as induction of controlled cavitation to mechanically homogenize targeted tissue by delivery of acoustic energy in the form of short (<50 microseconds) very high intensity pulses.
In other words, it is a focused ultrasound therapy which uses inertial cavitation(liquefying the tissue) to purposely destroy the tissue using short pulses with HIFU(high intensity focused ultrasound) Transducers.
The main goal of histotripsy is formation of a cavitation cloud made up of cavitation bubbles. This cavitation cloud has sharp boundaries differentiating the normal tissue and the disintegrated tissue at subcellular level. Histotripsy is considered a precise non-thermal ultrasonic scalpel due to its ability of precisely defining and treating a targeted area
University of Michigan has developed a noninvasive sound technology that causes breakdown of liver tumors, kills cancer cells and stimulates the immune system in rats.
Though the targeted tumor break down was 50-75%, the rat’s immune system clears off the remaining tumor, with no recurrence or metastases.
This technique is undergoing trials on cancerous human liver in Europe and the United States.
In many clinical situations, the cancer of a patient cannot be targeted for ablation because of many reasons, some of which include- site/location, stage, size. However, this treatment is focused at destroying tissue at millimeter precision.
“Even if we don’t target the entire tumor, we can still cause the tumor to regress and also reduce the risk of future metastasis,” said Zhen Xu, corresponding author of the study.
Researchers have been meaning to use this technique as a therapeutic tool to replace open heart surgery. Recent research have also demonstrated the potential of histotripsy for chordal cutting
“Histotripsy is a promising option that can overcome the limitations of currently available ablation modalities and provide safe and effective noninvasive liver tumor ablation,” said Tejaswi Worlikar, a doctoral student in biomedical engineering.
VIDEOGAME FOR HEALTH
3. ENDEAVOUR Rx-FDA approved video game gains a direct-to- patient product registry
Video games as a medicine/therapy…? It's news to me!
Digital therapeutics are evidence-based therapeutic interventions driven by software to prevent, manage, or treat a medical disorder or disease. Digital therapeutics(DTx) is a new world of possibilities.
One of the approved DTx is ENDEAVOUR Rx.
This is a video game known for its therapeutic effect in patients aged 8-12 having ADHD.
The game is designed in such a way that the challenges, missions, and targets in the game focuses on the areas of the brain that deal with attention. It helps the patients multitask, while ignoring other distractions.
Although the video game was launched in the year 2020, this year it gained a fully remote registry aimed at collecting real-world data from the patients.
“The data we will gain from the registry is critical for expanding the real-world evidence base for physicians, payors, and caregivers alike,” said Anil Jina, M.D., Chief Medical Officer of Akili.
Akili is the digital medicine company that announced the ENDEAVOUR Rx expedition product registry.
The direct-to-patient registry is fully remote and is open to any patient who has been prescribed EndeavorRx by their healthcare professional. It will provide insights into patient characteristics, usage patterns, and effectiveness of EndeavorRx in a real-world setting. Data from the registry will be used to help improve the experience and education around the product for patients and caregivers, and enable Akili to recapitulate its product based on feedback and data received.
What needs to be kept in mind is that ENDEAVOUR Rx cannot be used as a stand-alone therapy. It is used as an add-on to the standard prescription.
Digital therapeutics however isn't limited only to this video game, there are many new innovations. Some of which are:
Omada- Omada's approach tackles a host of chronic conditions, including diabetes, hypertension, and musculoskeletal (MSK) by combining behavioral science and clinical protocols.
Virta Health- Diabetes 2 reversal treatment
Biofourmis- for patient health management
mRNA TECHNOLOGY
4. Moderna and Pfizer-BioNTech- the only two companies working on mRNA technology for therapy
The COVID-19 vaccine was the first successful vaccine prepared through mRNA technology. Although the interest for development of mRNA technology was there since the 1960s, it didn’t gain momentum until the last two decades.
Moderna and BioNTech are the two companies working with mRNA for vaccine as well as therapy of diseases. mRNA technology however had not been successful through the years until Covid-19.
Fighting the SARS-CoV-2 has unlocked the power of mRNA technology.
Apart from COVID-19, the mRNA technology has been used to successfully formulate a new vaccine against Powassan virus-responsible for causing lyme disease from bite of tick.
It has shown good results, it was highly immunogenic and offered protection against multiple members of the family.
mRNA has also proved to be an excellent approach for target therapy. “We found that by introducing mRNA in immune cells, it is possible to produce useful proteins to improve their anti-tumor activity without attempting to change the genome itself,” Dr. Haidong Dong, a professor of immunology at the Mayo Clinic.
Moderna also has several investigational oncology treatments which includes mRNA-4157, a personalized cancer vaccine in Phase 2 of trials. In unresectable solid tumors and resected cutaneous melanoma, mRNA-4157 with Keytruda (pembrolizumab) was well tolerated and was associated with tumor shrinkage in the Phase 1 of the study.
BioNTech also has oncology product nominees in development, which includes BNT111 for advanced melanoma, BNT112 for prostate cancer, BNT113 for HPV16+ head and neck cancer and BNT115 for ovarian cancer. In Phase 3 studies are BNT111 and BNT113 .For SAR441000, a saline-formulated mixture of four mRNAs targeting a solid tumor indication, BioNTech is also partnering with Sanofi.
Centre for Cellular and Molecular Biology (CCMB) and Council Of Scientific And Industrial Research (CSIR) has developed India’s first indigenous mRNA (Messenger RNA) vaccine technology to fight against Covid-19.
Thus, mRNA technology is moving ahead with a promising future for therapy of different diseases.
Here were the 3 innovations of the year 2022.
As the researchers from all over the world have geared up now that the pandemic’s over(God bless), these are not the only ones of this year.
We will be back with 3 more in the next post.
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